The traditional approach in the treatment of hypothyroidism
is to use the synthetic hormone thyroxine (T4), which contains T4 hormone
only; it has no triiodothyronine (T3).
You will often find that when you attempt to ask your physician for the natural desiccated porcine thyroid extract that you are often made to feel quite stupid that you would dare to request an inferior hormone product from him/her. Unfortunately, physicians have little knowledge about this product as teaching about it in medical schools stopped suddenly in 1975 and they are untrained in its use. (See 'Background Information')
Medical practitioners will often tell you that the synthetic provides steady hormone levels, but what s/he tend to overlook is that a large minority of people are unable to convert the T4 to the active form of thyroid, triiodothyronine (T3). Your doctor could easily confirm this if s/he measured the free hormone levels when they give you a thyroid function test, but not many of them even bother to use these tests.
If you have low T3 levels, which are typical when using synthetic hormone, the brain and body just doesn't function properly. You must use a preparation that contains T3 because T3 does 90% of the work of the thyroid in the body. You should use a combination of T4 and T3 that compensates for the inability by some people to convert T4 to T3. Armour thyroid is desiccated thyroid and has T3 and T4 plus calcitonin and probably (unassayed) T2 and T1 plus other essential hormones.
Desiccated thyroid extract can be used by itself, as a complete thyroid hormone replacement product, sometimes in combination with synthetic T4 or T3 to change the ratio of T4 to T3. The ratio of T3 to T4 is fixed, so it can't be adjusted unless T4-only or T3-only pills are taken as well.
Nearly all doctors in natural medicine tend to use Armour Thyroid, which
is a mixture of mono and di-iodothryonine and T3 and T4, the entire range
of thyroid hormones.
The dosage of Armour thyroid is determined by the indication and must in every case be individualized according to patient response and laboratory findings. The safest starting dose for patients with hypothyroidism who are taking Armour thyroid is usually instituted using low doses depending on the cardiovascular status of the patient.
The usual starting dose is 30 mg (1/2 grain) with increments of 15 mg (1/4 grain) every 2 to 3 weeks. A lower starting dosage, 15 mg (1/4 grain) per day is recommended in patients with long standing hypothyroidism, particularly if cardiovascular impairment is suspected, in which case extreme caution is recommended. Armour should be taken twice a day, half after breakfast and the other half after lunch. The tablet can be cut in half with a pill cutter (available from most chemists). Taking Armour after meals also helps to reduce volatility of the blood-level of T3. The TSH, Free T3 (if possible!) and Free T4 are then repeated in six weeks and the dose is adjusted. Unlike thyroxine, whose coating needs breaking down in the stomach, Armour can be taking sublingually, under the tongue, which means it is absorbed straight into the blood stream to work instantly, and can be taken at the same time as foods which may otherwise interfere with it.
Taking thyroid extract twice a day overcomes traditional medicine's major objection and resistance to using natural thyroid preparations - its variability in its blood-levels. Your doctor may not be aware that Armour thyroid should be used twice daily and NOT once a day. The reason for this is that T3 has such a short half-life and needs to be taken twice daily to achieve consistent blood levels.
The dose should be increased on a monthly basis until the TSH falls below 0.4. You then need to optimise these two thyroid hormones by using the Free T4 and Free T3 levels.
The FT3 and FT4 tests are used to monitor your treatment. They should be above the middle but below the upper end of the laboratory normal reference range. Healthy young adults should have numbers close to the upper part of the range. For cardiac and/or elderly patients, the numbers should be in the middle of its range. Once a therapeutic range is achieved the levels should be checked at least once a year. A small number of large, overweight, thyroid-resistant patients may need high doses of Armour thyroid or the equivalent of thyroxine per day (counting 100mcg of T4 as 1 grain of Armour Thyroid).